{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T06:10:08Z","timestamp":1758953408260,"version":"3.44.0"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009993","name":"Center for Clinical and Translational Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009993","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective(s)<\/jats:title><jats:p>To measure clinical outcomes and respiratory trajectories after the placement of virtually assisted personalized tracheostomy tubes (vapTT) designed for patients with congenital airway anomalies (CAA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review was performed of vapTT candidates, which included patients with CAA experiencing recurrent respiratory failure due to ongoing TT obstruction despite exhaustion of commercially available TT. VapTT design used a previously reported protocol for virtual modeling from CT images correlated with endoscopy findings. Outcomes obtained from medical records included the presence of TT\u2010related granulation\/ulceration, symptomatic tracheoscopy frequency, progression of inpatient care, ventilatory parameters, and serum bicarbonate levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six patients were included. CAA pathology included tracheal cartilaginous sleeve, tortuosity, and stenosis in the setting of conditions such as craniosynostosis syndromes, skeletal dysplasia, and long\u2010gap esophageal atresia with scoliosis. Three patients were hospitalized for greater than 5\u2009months at the time of vapTT implementation; all three demonstrated improvement in acute obstructive events, resolution of granulation on tracheoscopy, significant improvement in serum bicarbonate (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.005), and progression of care to discharge. Of the three outpatients undergoing vapTT implementation, one patient experienced resolution of recurrent tracheitis and one had resolution of acutely symptomatic airway events. For the group, there was a significant decrease in compiled serum bicarbonate levels after vapTT implementation (3.6, 95% CI: 2.85\u20134.31, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>VapTT is a feasible option when airway obstruction cannot be overcome with standard TTs in children with CAA. Our early experience with vapTT demonstrated improved respiratory function without significant adverse events. Future studies are required to investigate long\u2010term outcomes of vapTT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.32257","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:43:45Z","timestamp":1748335425000},"page":"3898-3904","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Virtually Assisted Personalized Tracheostomy Tubes for Congenital Airway Anomalies"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6869-3339","authenticated-orcid":false,"given":"Anna Christina","family":"Clements","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology Seattle Children's Hospital  Seattle Washington, DC USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Washington  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean S.","family":"Evans","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children's Healthcare of Atlanta  Atlanta Georgia USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blair","family":"Mockler","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology Seattle Children's Hospital  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1462-2957","authenticated-orcid":false,"given":"Clare","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Phoenix Children's Hospital  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5308-527X","authenticated-orcid":false,"given":"Randall A.","family":"Bly","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Seattle Children's Hospital  Seattle Washington, DC USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Washington  Seattle Washington, DC USA"},{"name":"Center for Respiratory Biology and Therapeutics Seattle Children's Research Institute  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2961-6058","authenticated-orcid":false,"given":"Kaalan E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Seattle Children's Hospital  Seattle Washington, DC USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Washington  Seattle Washington, DC USA"},{"name":"Center for Respiratory Biology and Therapeutics Seattle Children's Research Institute  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth D.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Center for Respiratory Biology and Therapeutics Seattle Children's Research Institute  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Dahl","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Seattle Children's Hospital  Seattle Washington, DC USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Washington  Seattle Washington, DC USA"},{"name":"Center for Respiratory Biology and Therapeutics Seattle Children's Research Institute  Seattle Washington, DC USA"},{"name":"Division of Pediatric Otolaryngology Children's Mercy  Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Seattle Children's Hospital  Seattle Washington, DC USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Washington  Seattle Washington, DC USA"},{"name":"Center for Respiratory Biology and Therapeutics Seattle Children's Research Institute  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7174-7609","authenticated-orcid":false,"given":"Juliana","family":"Bonilla\u2010Velez","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Seattle Children's Hospital  Seattle Washington, DC USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Washington  Seattle Washington, DC USA"},{"name":"Center for Clinical and Translational Research Seattle Children's Research Institute  Seattle Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sempedsurg.2021.151055"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29747"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010199511000\u201000014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2017.07.063"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2024.112129"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998221126180"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000078"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.393"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-01183-x"},{"issue":"8","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1097\/SCS.0000000000009627","article-title":"Tracheostomy, the Not So Definitive Airway?: Tracheostomy Morbidity in Pediatric Craniofacial Patients","volume":"34","author":"La\u2010Anyane O. M.","year":"2023","journal-title":"Journal of Craniofacial Surgery"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.05.010"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2016.03.001"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.03.020"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110533"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820911728"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.105.2.550"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2014-208189"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30743"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.32257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T05:50:16Z","timestamp":1758952216000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.32257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/lary.32257"],"URL":"https:\/\/doi.org\/10.1002\/lary.32257","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2025,5,12]]},"assertion":[{"value":"2025-01-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}